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Please help me understand my MRI report

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Unread 11-27-2012, 04:10 AM   #31
tdouglas
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Originally Posted by Dubious View Post
tdouglas,

You have a central canal that is severly choked down. Only your clinician knows your exam findings and can make a determination for ESI or not. But if conservative management, oral non-steroidal and steroidal anti-inflammatory medication, PT, etc., has all failed, then why not go for the ESI?

I can't tell you how many times I've seen such a procedure drag someone out of the depths and despair of surgical consideration. ESI too may fail, but if your doc is recommending it, at least you won't go into (potentially) surgery without a fight! And believe me that ESI is a hiccup compared to the inconvenience and disruption to your life that decompressive surgery would be!
Thank you for your take on the situation. I'm definitely getting the injection in about a week, so no worries there. The neurosurgeon didn't seem to think it would help much, though, so I'm not expecting much from it. Of course, I'd be ecstatic if I could get relief from it and finally be pain-free for the first time in 16 months. I did forget to ask what procedure I would need, but my follow-up is on the 17th of next month, so it's not too far away. I used to think it would be a laminectomy, but now I don't think that's correct.

I'm going to do a ton of research on the injections and find out just how successful they are and find out what I can reasonably expect.
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Unread 11-27-2012, 04:37 AM   #32
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I am sorry that I missed this until now. Could it heal on it's own? There are some studies that suggest that they could heal themselves if they are bulging and not torn or prolapsed. This can be achieved by physical therapy and injection type therapy. I personally think the injection therapy is something they are forcing down our throats because they can charge and be paid for an outpatient surgery! I have not had personal success with either, and I don't know a single person who has and I know A LOT of spine patients!

Can it move left or right? It can in essence, if it were to prolapse or for a lack of a better analogy, terminology, and visual reference, squirt out and move left or right. I would be referring to the nucleus here and it it what mine did only because it had no where else to go. It stays in the general area, and that area isn't large at all. It could be positioned more to one side or the other and still remain central. That was harder to explain than I thought lol

The doctors are on me to have the surgery, YES! I have not had it, and I will not have it until I 1. can't take it no more 2. can't walk at all 3. defecate on my shoes. Kinda graphic but that's how I feel. My mom had her's fused in 82 and I grew up watching that nightmare scenario unfold so for me it is an ultimate last option. I have had 2 neck surgeries now, those were necessary and unavoidable (VERY similar to your condition only in my neck). What I have been told about the back at those locations is that it could permanently affect bladder/bowel function, walking, and sexual function.

That all being said I agree with the other's it is a case by case scenario. True I am not a doctor, but I am very well versed with these things as is most other's here from having to deal with it first hand. I can also tell you that what I saw on your reports your surgeon seemed to see the same thing, it is severe central stenosis. What makes this a problem is your cord is being compromised and at a point where, not the pain, but the preservation of the cord is at risk. There is no more room for error. The type of surgery most often used for this is decompression or laminectomy. However if there is any sign of DDD then they will most likely want to fuse. All of that being said I would have a thorough discussion with the surgeon and ask EVERYTHING you want to ask and he/she should be able to answer them all immediately and appropriately. I always recommend a second opinion to a surgeon OUTSIDE of that hospital or medical firm completely independent of the first.

Not trying to scare you or be doom and gloom, just trying to put it into layman's terms. I will pray for you and I wish you the best. PLEASE get that second opinion soon!
Thanks for taking the time to explain. I understood it clearly (or I think I did, at least ). I am against surgery for many reasons, so I can see why you are waiting on it. In my case, though, this pain is affecting my ability to work even the most menial job, and the longer it lingers, the longer I'm putting off finishing college and starting a career. It's a serious cause of frustration for me.

Like I said, I will be ecstatic if this injection will alleviate my pain, but I'm worried about any permanent damage that I either already have or will eventually have if the severe stenosis doesn't get dealt with. I was quite surprised at how blunt my doctor was about having surgery: he said that even though I'm a younger guy, he didn't want to wait very long to make the call for surgery or not because of the severity of the issue. He said he wanted me to do the pt and injection to make sure he covered all the bases before resorting to surgery. I'm not sure what three weeks of physical therapy could do, but I'm willing to try it if it gets me to a solution sooner. If we decide on having the surgery, I'll definitely have a large list of questions ready to ask.

Again, I appreciate your support, as well as everyone else who has taken the time to comment in this thread. Without you guys, I'd be going insane, trying to decipher this MRI report, and I'd probably end up with some very wrong conclusions, like assuming my legs are going to fall off or something.
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Unread 11-27-2012, 08:45 AM   #33
ginnie
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Default Hi Tdouglas

The reason why I am a bit leary of injections is they are NOT regulated as of yet by the FDA. Steriod shots need to come into compliance as well as the other medicines we take.
Sean said that mild Yoga, is a good beginning. It allows gentle stretching of the body, and does not tax any one joint in the back. He did say alot about massage. If you have a friend, or even a health club, they can do massage. When I was recoverying from my surgery, 90% those first two weeks were spent with massage, and only 10% on strength building. You start with small gentle movement, and increase over time. His take on it, was if there is surgery a possible, then to do no harm, and only be gentle. He agreed no chiropractic, unless cleared from a neruo surgeon. If it hurts, stop. I will try to get some specifics written out for you as well. Look into Lidocane patches, as they can relieve some of the pain. Most are covered under insurance programs. I will stay in touch. ginnie
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Unread 12-04-2012, 11:31 AM   #34
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I don't have an update yet, but I'm getting the epidural steroid shot tomorrow, and I have a question. Over the past couple of months or so, while I sleep, I get woken up by a burning sort of numbness that runs down the outside of my right thigh. It's hard for me to explain exactly how it feels, but the best I can do is that it is very numb to the touch, but it also has an uncomfortable burning to it. This burning happens when I sleep with my right leg extended out, and when I wake up from the discomfort, I move my right leg around and keep it bent, and after 10-15 minutes, it goes away. I was wondering if anyone had any explanation for this. I assume that a nerve is being compressed, but I don't know if it's something to worry about.

Also, there's something I haven't really paid attention to, but it dawned on me that I should explore it -- my upper spine/neck region is also painful and has been for over a year. Whenever I bend my neck downwards (chin to my chest), I get a pain in my neck, upper spine, and mid-spine. I can also feel pain in my lower back on the right side (where most of my major pain is). It is at its worst when I wake up in the morning, to the point where I can barely move my head. I was wondering if you guys thought I should explore getting an MRI on that, or if you think it's just the symptoms of DDD.

Finally, I've been reading up on ankylosing spondylitis, and a lot of it sounds like what I have. There's the obvious lower back pain, but I've also had joint pain in my knees, shoulders, and hip, and unexplainable breastbone and rib pain for years (the symptoms of costochondritis). I also have pain that basically runs down both sides of my body, like where the muscle attaches to the bone and general fatigue. None of this is particularly debilitating (except the lower back pain), and I guess I haven't thought much about it because I've been dealing with it for so long that being in pain is my new normal. I'm going to bring this up with my neurosurgeon on the 17th, but I was wondering if you guys know anything about this disease.

I know I'm asking a ton of questions, so if anyone can help with any of this, I totally appreciate it. I don't want to start sounding sappy, but you guys have been so awesome to me, and you've really helped me get through this whole process.
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Unread 12-04-2012, 04:46 PM   #35
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Default Hi TDouglas

Hope the shot gives you some relief. You know we are not professionals, but you did say alot of symptoms that are considered Neurological in nature. Therefor I would be inclined to get an MRI of the spine, to make sure you do not have nerve inpingment of the cord. The neck pain you described can be from a number of things. May I ask what you do for a living? feel better soon, ginnie
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Unread 12-04-2012, 06:12 PM   #36
tdouglas
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Hope the shot gives you some relief. You know we are not professionals, but you did say alot of symptoms that are considered Neurological in nature. Therefor I would be inclined to get an MRI of the spine, to make sure you do not have nerve inpingment of the cord. The neck pain you described can be from a number of things. May I ask what you do for a living? feel better soon, ginnie
I think I'll ask my neurologist to order up an MRI on my neck and upper spine, just to be safe. As for my job, I've been a student until recently, and I've been running an online store, so there's been a minimal amount of physical labor. The most strenuous thing I've done is run Cross-Country in high school, but that was five years ago. I did get stress fractures in both of my legs from that, but that should be unrelated to my back problems.
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Unread 12-05-2012, 08:25 PM   #37
tdouglas
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Small update. I had my shot today. I was ecstatic to feel almost total relief from the anesthesia. Unfortunately, it made me notice my knee and hip pain more. The anesthesia has already worn off, and I'm feeling about the same amount of pain I always have. I'll monitor the situation closely over the next week and see what happens.

I talked to my primary care doctor today for the first time since I got my MRI results. She was unsurprisingly much more open to giving me pain medication; she even apologized for it taking so long for me to get some. I understand that she didn't want to give a 22 year old narcotics without proof of pain. I could have been any other drug junkie. After telling her all of my symptoms, she seemed to agree that ankylosing spondylitis could be a very real diagnosis. She ordered blood tests to test for the blood marker that is found in 90%+ of AS patients. I know this is a back forum, but I've been having pretty bad knee pain and hip/groin pain for at least a year, so I'm getting X-Rays and MRI's done on those areas soon. Also, I'm getting my cervical spine imaged, too. I'm not expecting more than some basic DDD being there, but it does hurt quite a bit, and problems with the spinal cord up there scares me.

I finally feel like I'm getting somewhere with all of this. I don't want to make this my personal blog, so I'll try not to clog up the board with unnecessary posts. I'll still be checking daily for any advice you guys may have, though (I still really, really need it!). You guys are awesome!

Last edited by tdouglas; 12-05-2012 at 09:36 PM.
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Unread 12-05-2012, 09:15 PM   #38
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Originally Posted by tdouglas View Post
Small update. I had my shot today. I was ecstatic to feel almost total relief from the anesthesia. Unfortunately, it made me notice my knee and hip pain more. The anesthesia has already worn off, and I'm feeling about the same amount of pain I always have. I'll monitor the situation closely over the next week and see what happens.

I talked to my primary care doctor today for the first time since I got my MRI results. She was unsurprisingly much more open to giving me pain medication; she even apologized for it taking so long for me to get some. I understand that she didn't want to give a 22 year old narcotics without proof of pain. I could have been any other drug junkie. After telling her all of my symptoms, she seemed to agree that ankylosing spondylitis could be a very real diagnosis. She ordered blood tests to test for the blood marker that is found in 90%+ of AS patients. I know this is a back forum, but I've been having pretty bad knee pain and hip/groin pain for at least a year, so I'm getting X-Rays and MRI's done on those areas soon. Also, I'm getting my cervical spine imaged, too. I'm not expected more than some basic DDD being there, but it does hurt quite a bit, and problems with the spinal cord up there scares me.

I finally feel like I'm getting somewhere with all of this. I don't want to make this my personal blog, so I'll try not to clog up the board with unnecessary posts. I'll still be checking daily for any advice you guys may have, though (I still really, really need it!). You guys are awesome!
Whoa....what a minute! You had all of those degenerative changes in your spine with severe central stenosis....at the age of 22? Something is missing or afoul...??

You are about the right age for AS; I am assuming you had a positive HLAB27 on your labs, when you speak of a marker? Usually a panel is run along with that...including ANA, CRP, sed rate and rheum factor (sometimes CBC if RA is suspect as anemia is associated with it). Did you have those too? Sounds like you'll soon be visiting (or should be) your friendly rheumatologist!
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Unread 12-05-2012, 09:25 PM   #39
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Whoa....what a minute! You had all of those degenerative changes in your spine with severe central stenosis....at the age of 22? Something is missing or afoul...??

You are about the right age for AS; I am assuming you had a positive HLAB27 on your labs, when you speak of a marker? Usually a panel is run along with that...including ANA, CRP, sed rate and rheum factor (sometimes CBC if RA is suspect as anemia is associated with it). Did you have those too? Sounds like you'll soon be visiting (or should be) your friendly rheumatologist!
Yep, I'm only 22. And the pain started when I was barely 21. Like you said, all of my symptoms fit AS -- I'm the right age and gender, I have the obvious back pain, I have symptoms of costochondritis, I'm having joint and tendon issues with my knees, hip, feet, and hands, and more. I've done a ton of research on AS and I actually suggested to my primary care doctor that we should explore AS today and she agreed. I just had blood drawn today to test for the HLAB27 factor. I'm assuming they will check the sedimentation rate, but I didn't ask. I had a blood test done to rule out RA a while ago, and I was at least cleared of having the RA factors.

Last edited by tdouglas; 12-06-2012 at 03:09 AM.
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Unread 03-01-2013, 07:04 PM   #40
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I thought I would update you guys on my situation. I had the discectomy surgery about three weeks ago to shave down that disc. The neurosurgeon said it was one of the worst cases he's ever seen, and he was surprised I could even walk. He told me there was only a 60% chance the surgery would alleviate the pain in my back, and it seems like I'm in the other 40% right now. I'm still hopeful that after six weeks (the recommended recovery time), the pain will be gone, but as of right now, I'm still feeling about the same amount of pain I was before the surgery.

I've got a follow-up appointment in a few weeks, so we'll figure out what's next for me. I was in immense pain for about a week after the surgery, so if he suggests a lumbar fusion, I'll probably decline it. I don't want to go through that again. Of course, there are other negatives to having a lumbar fusion at my age as well.
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